Do Your Toenails Get Thicker as You Age? The Medical Answer

As many as 50% of people over the age of 70 experience some form of nail condition, making the question, Do your toenails get thicker as you age? a common and medically relevant concern. This natural phenomenon, while normal, can also be a symptom of more significant underlying issues.

Quick Summary

Yes, toenails do commonly thicken with age due to slowed growth and increased cell accumulation, though it's important to distinguish this from other causes like fungal infections, repeated trauma, and certain medical conditions that can also contribute to the issue.

Key Points

• Age is a factor: As you age, your nails grow slower, leading to a natural buildup of keratin that causes thickening.

• Fungus is often a cause: Onychomycosis, a common fungal infection, is a frequent reason for toenails to thicken, discolor, and become brittle.

• Trauma plays a role: Repetitive micro-trauma from ill-fitting shoes or a single injury can permanently damage the nail bed, resulting in thicker nails.

• Underlying health conditions matter: Conditions like diabetes, psoriasis, and poor circulation can contribute to or cause toenail thickening.

• Proper care is essential: Regular foot soaking, correct trimming with proper tools, and wearing well-fitting footwear can help manage thickened nails.

• Seek professional help: If thickening is painful, discolored, or you have an underlying condition like diabetes, it's best to see a podiatrist.

The Physiological Reasons for Age-Related Toenail Thickening

Over time, our bodies undergo numerous changes, and our nails are no exception. The process by which our nails grow and regenerate slows down considerably as we get older. Nail plates are made of a protein called keratin. As we age, the growth rate of these keratin cells decreases, but the shedding rate does not always keep pace. This can lead to an excessive buildup of nail cells, resulting in a nail plate that becomes progressively thicker and harder over time.

This condition is medically known as onychauxis, the simple hypertrophy or overgrowth of the nail plate. It is often benign and a normal part of the aging process. However, the thickening can lead to several problems, including increased risk of ingrown toenails and general discomfort when wearing shoes.

Other Common Causes of Thick Toenails in Seniors

While aging is a primary factor, several other common issues can cause or worsen toenail thickening in older adults. It is important to identify the root cause, as treatment and management strategies will vary.

Fungal Infections (Onychomycosis)

This is one of the most frequent culprits behind thickened toenails, particularly in older individuals. Fungi can invade the nail bed through small cracks or separations, causing the nail to thicken, become discolored (often yellow, white, or brown), and turn brittle. Fungal infections can be contagious and are often associated with walking barefoot in public, moist areas like locker rooms or pools.

Repeated Trauma

Chronic, repeated microtrauma to the toenails is another significant cause of thickening. This can be the result of years of wearing poorly fitting shoes that put constant pressure on the toes, or from activities that involve repeated stress, such as running. The nail responds to this trauma by thickening as a protective mechanism, similar to how a callus forms on the skin. A single, severe injury, like dropping an object on your toe, can also damage the nail matrix, causing it to grow back thicker.

Systemic Health Conditions

Certain medical conditions can manifest in the nails, including:

• Diabetes: Reduced blood flow to the feet, a common complication of diabetes, can impair nail growth and lead to thickening. Individuals with diabetes must be particularly vigilant about foot health to prevent infection.
• Psoriasis: This autoimmune disease, known for causing scaly patches on the skin, can also affect the nails, causing them to thicken, pit, and separate from the nail bed.
• Peripheral Arterial Disease (PAD): This condition involves narrowed arteries that reduce blood flow to the limbs. The reduced circulation can cause nails to thicken and become brittle.
• Yellow Nail Syndrome: A rare disorder causing slow-growing, thickened, yellow, and curved nails, often accompanied by respiratory problems.

Comparison: Aging vs. Fungal Toenails

Distinguishing between natural age-related changes and a fungal infection is crucial for appropriate care. Here is a comparison to help identify the differences:

Feature	Age-Related Thickening (Onychauxis)	Fungal Infection (Onychomycosis)
Appearance	Uniform, harder, dull or yellowed	Discolored (yellow, white, brown), brittle, crumbly
Odor	Typically no odor	Foul, unpleasant odor common
Progression	Gradual, slow thickening	Often begins with spots or streaks, spreads over time
Associated Symptoms	Can cause discomfort from pressure	Itching, pain, or lifting of the nail from the bed
Affected Nails	Tends to affect most toenails	Often affects one or a few nails, can spread
Texture	Hard, opaque, rigid	Dry, chalky, powdery buildup under the nail

Tips for Managing and Caring for Thickened Toenails

Managing thick toenails can improve comfort and prevent further issues. Here are some effective strategies:

1. Soak Your Feet: Before trimming, soak your feet in warm water for 10–15 minutes to soften the nails. Adding Epsom salts can help further.
2. Use the Right Tools: Invest in heavy-duty, professional-grade toenail clippers or nail nippers designed for thicker nails. Avoid using standard fingernail clippers, which can cause splitting.
3. Trim Correctly: Cut the nails straight across, not curved, to prevent ingrown toenails. Make several small cuts rather than one large one to avoid splintering. Leave the nail long enough to get a fingernail underneath.
4. File Gently: After trimming, use a file to smooth any sharp edges. Filing can also help to thin the surface of the nail and reduce its bulk.
5. Wear Proper Footwear: Choose shoes with a wide and deep toe box to minimize pressure on the nails. Laced or Velcro-fastening shoes are often ideal for a better fit.
6. Maintain Hygiene: Keep feet clean and dry. In shared, wet spaces like public showers, wear flip-flops to prevent fungal infections.

When to See a Podiatrist

While some toenail thickening is a normal part of aging, it is important to seek professional help in certain circumstances. You should see a podiatrist if:

• Your toenails become painful.
• You suspect a fungal infection due to discoloration or odor.
• You have diabetes, which puts you at higher risk for complications.
• At-home care and trimming become too difficult or risky.
• The nail changes suddenly or significantly in appearance.
• The nail separates from the nail bed (onycholysis).

A podiatrist can properly diagnose the cause, perform professional debridement (filing down the nail), and recommend targeted treatment for fungal infections or other underlying issues.

Conclusion

Yes, toenail thickening is a common and often normal consequence of aging. However, it is not something to be ignored. Understanding the difference between natural changes and other contributing factors, such as fungal infections, trauma, and systemic diseases, is key to proper foot care. By practicing good hygiene, wearing appropriate footwear, and seeking professional help when needed, you can effectively manage thick toenails and maintain your foot health throughout the aging process. Remember, consistent care is the best way to prevent complications and ensure comfort for your feet.

For more detailed information on foot health and aging, the American College of Foot and Ankle Surgeons is a trusted resource.

Frequently Asked Questions

Is it normal for my toenails to get thicker as I age?

Yes, it is common for toenails to thicken with age due to a natural slowing of the growth process. This gradual change, called onychauxis, is generally harmless but can be uncomfortable.

Can thick toenails be a sign of a fungal infection?

Yes, a fungal infection (onychomycosis) is a very common cause of thickened toenails. Unlike age-related thickening, fungal nails are often discolored, brittle, and may have a foul odor. It's important to have a doctor or podiatrist diagnose the cause.

How can I tell if my thick toenails are from age or fungus?

Age-related thickening is typically a gradual, uniform process across multiple nails. Fungal nails, however, are often yellowed or discolored, crumbly, and may affect only one or a few nails. A podiatrist can provide a definitive diagnosis.

What's the best way to trim thick toenails?

First, soak your feet in warm water to soften the nails. Use heavy-duty, clean clippers and make small, straight cuts across the nail. Afterward, use a file to smooth the edges. Never round the corners, as this can cause ingrown nails.

Do ill-fitting shoes contribute to thick toenails?

Yes, wearing shoes that are too tight or narrow can cause repetitive micro-trauma to the nails, which can cause them to thicken over time as a protective response. Choosing shoes with a wide and deep toe box is recommended.

Can I treat thick toenails at home with remedies like Vicks VapoRub?

Some people find relief with home remedies, such as applying Vicks VapoRub or tea tree oil, but their effectiveness can vary. It is best to consult a healthcare provider for persistent or severe thickening, especially if it's due to a fungal infection.

When should a senior see a doctor for thick toenails?

A senior should see a podiatrist if the nails are painful, causing discomfort, show signs of infection, or if they have diabetes or another condition affecting circulation. A professional can ensure safe trimming and proper treatment.